Blunt Chest Trauma with Cardiac Ruptures in Eastern Taiwan

Abstract

Objective: Blunt chest trauma with cardiac rupture is uncommon. A prompt diagnosis and treatment of this condition can save lives. This report reviews the outcomes and treatment of nine patients in eatern Taiwan who presented with cardiac rupture caused by blunt chest trauma. Patients and Methods: From January 1996 to January 2001, nine patients with cardiac rupture were oper-ated on at Tzu Chi General Hospital. Eight patients had associated injuries. Three patients presented with undetectable blood pressure, four with massive hemothorax, four with cardiac tamponade, one with acute pulmonary edema, eight with cardiac ruptures of the right atrium, left atrium, left atrium, or both, and one with posteromedial papillary muscle rupture. Four patients received a thoracotomy, and five received a sternotomy to repair the heart or repair the heart or replac the mitral vale. Results: Prolonged shock after surgery caused the deah of the four patients with massive hemothorax. Four of five patients survived the strnotomy. The fifth patient died because of a delayed diagnosis in the emergency room. Conclusions: Patients who present with massive hemothorax have a poor prognsis. Prompt diagnosis and treatment of patients with cardiac tamponade or traumatic mitral regurgitation complicated with pulmonary edema generally produces goood results.(Tzu Chi Med J 2003; 15:27-31)